Cryoglobulinemia history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
History and Symptoms
- Palpable purpura, arthralgias, and neuropathy are common findings.
- Nonspecific systemic complaints, hepatosplenomegaly and hypocomplementemia are noted.
- Low-grade Non-Hodgkins lymphomas may occur with increased frequency among these patients.
- Renal disease occurs in 20% of patients at diagnosis and eventually develops in up to 60%, usually after the development of purpura.
- Renal involvement is more common in Type II than Type III MC.
- Most patients present with ayamptomatic hematuria and poteinuria, but frank nephrotic syndrome and acute renal failure can develop.
- The characteristic findings on renal biopsy are
- Intraluminal thrombi
- Diffuse IgM deposition in the capillary loops
- Subendothelial deposits in a “curvilinear” pattern on EM.
- Only 14% develop end stage renal disease (ESRD) at 10 years after a renal biopsy demonstrates MC.
- Recurrent MC can affect up to 70% of transplanted kidneys, but does not preclude transplantation since most of these grafts do not fail.